中国三省成人尿钠钾水平与血压的关联

李晴; 吴贝可; 刘敏; 辛雨泽; 于欢; 田懋一; 徐建伟

doi:10.16462/j.cnki.zhjbkz.2025.09.012

中国三省成人尿钠钾水平与血压的关联

doi: 10.16462/j.cnki.zhjbkz.2025.09.012

1.
中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
2.
哈尔滨医科大学公共卫生学院流行病学教研室, 哈尔滨 150081

基金项目:

四大慢病重大专项 2024ZD0524600

澳大利亚国家健康与医学研究理事会以及全球慢性疾病合作联盟资助 APP1169751

详细信息

通讯作者:
徐建伟, E-mail: xujianwei@ncncd.chinacdc.cn

中图分类号: R181.2+3
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出版历程
- 收稿日期: 2025-03-07
- 修回日期: 2025-05-06
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-10

Association between urinary sodium and potassium levels and blood pressure in adults in three provinces of China

LI Qing¹,
WU Beike²,
LIU Min¹,
XIN Yuze²,
YU Huan¹,
TIAN Maoyi²,
XU Jianwei^{1
, ,}

1.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
2.
Epidemiology Department of the School of Public Health, Harbin Medical University, Harbin 150081, China

Funds:

Noncommunicable Chronic Diseases-National Science and Technology Major Project 2024ZD0524600

Australian National Health and Medical Research Council and the Global Partnership for Chronic Diseases APP1169751

More Information

Corresponding author: XU Jianwei, E-mail: xujianwei@ncncd.chinacdc.cn

摘要

摘要: 目的分析中国三省成人尿钠钾水平与高血压患病风险及血压水平的关系。方法 2022―2023年采用多阶段随机抽样的方法, 对黑龙江省、贵州省和广东省18~69岁居民开展问卷调查、体格检查及尿液收集。使用SAS 9.4软件, 采用logistic回归和线性回归分析模型分析24 h尿和点尿钠钾水平与血压的关系。结果共纳入研究对象1 424名, 其中高血压患者500人(35.11%)。24 h尿钠钾水平与血压相关性分析结果显示: 与尿钠Q1组相比, Q2(OR=1.553, 95% CI: 1.061~2.271)、Q3(OR=1.560, 95% CI: 1.079~2.256)和Q4(OR=1.608, 95% CI: 1.108~2.333)组高血压患病风险增加; 与尿钠钾比Q1组相比, Q4组高血压患病风险增加(OR=2.763, 95% CI: 1.398~5.459);与尿钠Q1组相比, Q2、Q3和Q4组收缩压分别增加2.107 mmHg(95% CI: 0.033 mmHg~4.180 mmHg)、2.340 mmHg(95% CI: 0.316 mmHg~4.364 mmHg)和2.500 mmHg(95% CI: 0.183 mmHg~4.817 mmHg); 与尿钠钾比Q1组相比, Q4组收缩压增加3.311 mmHg(95% CI: 0.652 mmHg~7.274 mmHg)。点尿钠钾水平与血压相关性分析结果显示: 与尿钾Q1组相比, Q4组高血压患病风险下降(OR=0.633, 95% CI: 0.436~0.918);与尿钠钾比Q1组相比, Q3和Q4组高血压患病风险增加, OR值分别为1.463(95% CI: 1.011~2.117)和1.485(95% CI: 1.027~2.147);与尿钾Q1组相比, Q3和Q4组收缩压分别下降2.379 mmHg(95% CI: -4.664 mmHg~-0.094 mmHg)和3.137 mmHg(95% CI: -5.467 mmHg~-0.807 mmHg); 与尿钠钾比Q1组相比, Q3和Q4组收缩压分别上升2.867 mmHg(95% CI: 0.544 mmHg~5.190 mmHg)和3.256 mmHg(95% CI: 0.943 mmHg~5.568 mmHg)。结论尿钠钾水平与血压存在关联, 也证实了尿钠钾比对评估高血压患病风险具有一定可行性。
- 尿钠 /
- 尿钾 /
- 高血压 /
- 横断面研究
Abstract: Objective To analyze the relationship between urinary sodium and potassium levels and blood pressure among adults in three Chinese provinces. Methods From 2022 to 2023, a multistage random sampling approach was utilized to enroll residents aged 18-69 in Heilongjiang, Guizhou, and Guangdong provinces. SAS 9.4 software was used to analyze the relationship between sodium and potassium levels and blood pressure in 24-hour urine and spot urine using logistic regression and linear regression models. Results A total of 1 424 subjects were included in the study, among whom 500 (35.11%) had hypertension. The results of the correlation analysis between 24-hour urinary sodium and potassium levels and blood pressure indicated that compared to the first quartile (Q1) of urinary sodium, the risk of hypertension significantly increased in the second (Q2), third (Q3), and fourth (Q4) quartiles, with odds ratios (OR) of 1.553 (95% CI: 1.061-2.271), 1.560 (95% CI: 1.079-2.256), and 1.608 (95% CI: 1.108-2.333), respectively. The analysis of spot urine sodium and potassium levels showed that compared to the lowest quartile (Q1) of urinary potassium, the Q4 quartile exhibited a reduced risk of hypertension, with an OR of 0.633 (95% CI: 0.436-0.918). When compared to the urinary sodium-to-potassium ratio Q1 group, the Q3 and Q4 quartiles indicated an increased risk of hypertension with OR values of 1.463 (95% CI: 1.011-2.117) and 1.485 (95% CI: 1.027-2.147), respectively. In terms of standard deviation of blood pressure, the Q3 and Q4 groups compared to the Q1 quartile for urinary potassium exhibited decreases of 2.379 mmHg (95% CI: -4.664 mmHg-0.094 mmHg) and 3.137 mmHg (95% CI: -5.467 mmHg-0.807 mmHg), respectively. Conversely, Q3 and Q4 quartiles compared to the Q1 quartile of the urinary sodium-to-potassium ratio showed increases in SDP of 2.867 mmHg (95% CI: 0.544 mmHg-5.190 mmHg) and 3.256 mmHg (95% CI: 0.943 mmHg-5.568 mmHg), respectively. Conclusions There is a correlation between urinary sodium and potassium levels and blood pressure, which also supports the feasibility of using the urine sodium-to-potassium ratio to assess the risk of hypertension.
- Urine sodium /
- Urine potassium /
- Hypertension /
- Cross-sectional study

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表 1 1 424名研究对象基本情况

Table 1. Basic information of 1 424 participants

变量 Variable	总人群 Total population^① (n=1 424)	非高血压组 Non-hypertensive patients^① (n=924)	高血压组 Hypertensive patients^① (n=500)	t/χ²值 value	P值 value
年龄/岁Age/years	45.05±12.38	41.00±11.52	52.54±10.24	-18.74	< 0.001
性别Gender				8.88	0.003
女Female	703(49.37)	483(68.71)	220(31.29)
男Male	721(50.63)	441(61.17)	280(38.83)
文化程度Education				82.09	< 0.001
小学及以下Primary and below	453(31.81)	233(51.43)	220(48.57)
初中Junior high school	592(41.57)	382(64.53)	210(35.47)
高中及以上High school and below	379(26.62)	309(81.53)	70(18.47)
吸烟Smoking				7.72	0.006
是Yes	452(31.74)	270(59.73)	182(40.27)
否No	972(68.26)	654(67.28)	318(32.72)
食用低钠盐Low-sodium salt				4.09	0.043
是Yes	189(13.27)	135(71.43)	54(28.57)
否No	1235(86.73)	789(63.89)	446(36.11)
体质量指数Body mass index/ (kg·m^-2)	24.51±3.99	23.77±3.75	25.90±4.06	-9.95	< 0.001
SBP/mmHg	128.97±18.38	119.30±10.10	146.80±16.79	-33.52	< 0.001
DBP/mmHg	81.68±11.10	76.15±7.04	91.91±9.91	-31.52	< 0.001
尿肌酐Urine creatinine /(mmol·d^-1)	10.88±6.73	11.13±7.18	10.42±5.81	-2.14	0.033
24 h尿量Urine volume /(L·d^-1)	1 397.20±496.82	1 376.10±483.90	1 436.30±518.10	2.01	0.045
合计Total	1 424(100.00)	924(64.89)	500(35.11)
注: SBP, 收缩压; DBP, 舒张压。 ①以人数(占比/%)或x±s表示。 Note: SBP, systolic blood pressure; DBP, diastolic blood pressure. ① Number of people (proportion/%) or x±s.

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表 2 不同特征人群24 h尿和点尿钠、钾及钠钾比排泄情况

Table 2. 24-hour urinary and spot urine excretion of sodium, potassium and sodium-potassium ratio in different characteristic populations

变量Variable	合计 Total^①	24 h尿测量结果 24-hour urine measurement^②			点尿测量结果 Spot urine measurements^②
变量Variable	合计 Total^①	尿钠 Urine sodium /(mmol·d^-1)	尿钾 Urine potassium /(mmol·d^-1)	尿钠钾比 Urine sodium-to- potassium ratio	尿钠 Urine sodium /(mmol·d^-1)	尿钾 Urine potassium /(mmol·d^-1)	尿钠钾比 Urine sodium-to- potassium ratio
性别Gender
女Female	703(49.37)	163.17±92.75	37.78±22.99	5.25±2.72	147.96±75.90	44.03±26.15	4.24±2.85
男Male	721(50.63)	158.97±88.25	34.36±19.97	4.90±2.66	139.36±84.44	39.01±22.41	4.39±2.87
t值value		0.88	2.99	-2.45	2.02	3.90	-0.99
P值value		0.382	0.003	0.015	0.043	< 0.001	0.322
年龄/岁Age/years
18~ < 30	163(11.45)	170.02±107.67	36.67±21.11	5.31±3.56	150.01±77.99	41.58±23.33	4.39±3.11
30~ < 50	722(50.70)	164.45±94.24	37.01±23.08	5.08±2.62	148.06±73.79	43.74±25.38	4.26±2.76
50~69	539(37.85)	153.78±78.58	34.57±19.51	5.02±2.49	135.69±88.76	38.43±23.19	4.39±2.92
F值value		3.06	2.06	0.77	4.26	7.35	0.38
P值value		0.047	0.128	0.465	0.014	0.001	0.686
文化程度Education
小学及以下Primary and below	453(31.81)	164.83±85.63	36.82±22.80	5.22±2.70	150.56±94.71	43.25±25.65	4.41±2.96
初中Junior high school	592(41.57)	168.18±91.29	35.81±21.97	5.35±2.69	148.84±71.53	40.98±23.81	4.55±2.87
高中及以上High school and below	379(26.62)	145.38±93.21	35.50±19.42	4.50±2.62	127.10±72.47	40.17±23.90	3.85±2.68
F值value		8.00	0.44	12.31	11.09	1.86	7.28
P值value		< 0.001	0.642	< 0.001	< 0.001	0.156	0.001
体质量指数Body mass index
正常/体重过轻 Normal weight/under weight	685(48.11)	150.55±90.67	36.15±22.32	4.72±2.67	135.7±72.81	40.71±24.90	4.18±2.77
超重Overweight	507(35.60)	166.34±89.89	36.43±22.61	4.75±2.70	149.06±91.63	42.18±23.46	4.31±2.81
肥胖Obese	232(16.29)	180.48±87.36	35.08±20.81	5.35±2.63	155.02±73.32	42.27±25.22	4.76±3.20
F值value		10.98	1.31	12.39	6.87	0.67	3.52
P值value		< 0.001	0.269	< 0.001	0.001	0.510	0.030
吸烟Smoking
是Yes	452(31.74)	158.38±91.24	34.24±21.21	5.23±2.77	142.14±94.68	39.02±22.67	4.45±2.93
否No	972(68.26)	162.23±90.10	36.89±21.72	5.01±2.66	144.28±72.90	42.63±25.16	4.26±2.83
t值value		-0.77	-2.16	1.42	-0.43	-2.60	1.13
P值value		0.441	0.031	0.156	0.671	0.009	0.259
高血压Hypertensive patients
否No	924(64.89)	159.40±95.26	34.48±19.38	5.41±2.48	146.45±86.95	42.84±25.19	4.21±2.76
是Yes	500(35.11)	164.00±80.96	36.89±22.65	4.90±2.79	138.33±66.47	38.98±22.81	4.53±3.02
t值value		-0.95	2.11	-3.48	1.97	2.94	-2.02
P值value		0.341	0.035	0.001	0.049	0.003	0.039
合计Total	1 424(100.00)	164.01±80.96	36.04±21.59	5.08±2.69	143.60±80.43	41.49±24.45	4.32±2.86
注: ①以人数(占比/%); ② x±s表示。 Note: ① Number of people (proportion/%); ② x±s.

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表 3 24 h尿钠钾排泄水平与高血压患病风险及血压水平的相关性分析

Table 3. Correlation analysis between 24-hour urinary sodium and potassium excretion levels and the risk of hypertension and blood pressure levels

变量/结局 Variable/outcome	高血压患病风险Risk of hypertension OR值value(95% CI)		收缩压Systolic blood pressure β值value (95% CI)/mmHg		舒张压Diastolic blood pressure β值value (95% CI)/mmHg
变量/结局 Variable/outcome	模型1 Model 1	模型2 Model 2	模型1 Model 1	模型2 Model 2	模型1 Model 1	模型2 Model 2
24 h尿钠24 h urine sodium/(g·d^-1)
Q1(< 96.55)	1.000	1.000	1.000	1.000	1.000	1.000
Q2(96.55~ < 142.11)	1.536(1.118~2.110)^①	1.553(1.061~2.271)^①	2.741(0.045~5.436)^①	2.107(0.033~4.180)^①	1.640(0.011~3.270)^①	0.600(-0.884~2.084)
Q3(142.11~ < 202.74)	1.592(1.160~2.186)^①	1.560(1.079~2.256)^①	3.526(0.831~6.222)^①	2.340(0.316~4.364)^①	1.713(0.083~3.342)^①	1.036(-0.423~2.495)
Q4(≥202.74)	1.730(1.262~2.373)^①	1.608(1.108~2.333)^①	4.171(1.476~6.867)^①	2.500(0.183~4.817)^①	2.262(0.633~3.892)^①	0.864(-0.609~2.337)
24 h尿钾24 h urine potassium/(g·d^-1)
Q1(< 22.43)	1.000	1.000	1.000	1.000	1.000	1.000
Q2(22.43~ < 31.73)	1.416(1.044~1.919)^①	1.226(0.858~1.750)	2.997(0.303~5.691)^①	1.472(-0.847~3.791)	0.713(-0.918~2.343)	0.095(-1.365~1.555)
Q3(31.73~ < 44.30)	1.091(0.801~1.485)	1.047(0.726~1.508)	0.881(-1.813~3.575)	0.644(-1.676~2.965)	-0.742(-2.372~0.889)	-0.743(-2.204~0.718)
Q4(≥44.30)	0.812(0.591~1.114)	0.754(0.520~1.095)	-1.713(-4.408~0.981)	-1.452(-3.777~0.873)	-1.397(-3.027~0.233)	-1.229(-2.693~0.234)
24 h尿钠钾比 24 h urine sodium-to-potassium ratio
Q1(< 1.92)	1.000	1.000	1.000	1.000	1.000	1.000
Q2(1.92~ < 2.68)	1.649(0.840~3.240)	1.758(0.793~3.899)	1.397(-3.763~6.556)	1.216(-3.219~5.650)	1.490(-1.630~4.610)	1.454(-1.341~4.250)
Q3(2.68~ < 3.66)	1.761(0.944~3.284)	1.895(0.914~3.929)	1.681(-3.017~6.379)	0.920(-3.111~4.952)	1.844(-0.997~4.685)	1.479(-1.062~4.020)
Q4(≥3.66)	2.497(1.397~4.464)^①	2.763(1.398~5.459)^①	5.138(0.830~9.447)^①	3.311(0.652~7.274)^①	3.329(0.724~5.935)^①	2.124(-0.216~4.464)
注: 模型1, 未调整任何变量; 模型2, 二元logistic回归分析中, 调整了性别、年龄、体质量指数、文化程度、吸烟和食用低钠盐。多元线性回归分析中, 调整了性别、年龄、体质量指数、文化程度、吸烟、食用低钠盐和服用降压药。 ① P＜0.05。 Note: Model 1, no variables adjusted; Model 2, binary logistic regression analysis adjusted for gender, age, body mass index, education level, smoking, and low-sodium salt consumption. Multiple linear regression analyses were performed by adjusting for gender, age, body mass index, education level, smoking, consumption of low-sodium salts, and taking antihypertensive drugs. ① P＜0.05.

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表 4 点尿钠钾排泄水平与高血压患病风险及血压水平的相关性分析

Table 4. Correlation analysis between urinary sodium and potassium excretion levels and the risk of hypertension and blood pressure levels

变量/结局 Variable/outcome	高血压患病风险Risk of hypertension OR值value(95% CI)		收缩压Systolic blood pressure β值value (95% CI)/mmHg		舒张压Diastolic blood pressure β值value (95% CI)/mmHg
变量/结局 Variable/outcome	模型1 Model 1	模型2 Model 2	模型1 Model 1	模型2 Model 2	模型1 Model 1	模型2 Model 2
点尿钠 Spot urine sodium/(g·d^-1)
Q1(< 84.90)	1.000	1.000	1.000	1.000	1.000	1.000
Q2(84.90~ < 138.75)	0.876(0.639~1.199)	0.915(0.627~1.335)	-1.400(-4.100~1.301)	-0.595(-2.955~1.764)	-0.165(-1.796~1.466)	-0.168(-1.653~1.316)
Q3(138.75~ < 191.55)	1.008(0.739~1.376)	0.950(0.659~1.372)	-0.575(-3.275~2.126)	-1.152(-3.490~1.186)	0.836(-0.795~2.467)	0.147(-1.323~1.618)
Q4(≥191.55)	1.403(1.035~1.902)^①	1.390(0.970~1.992)	2.160(-0.539~4.859)	1.268(-1.045~3.581)	1.841(0.211~3.471)	1.277(-0.178~2.732)
点尿钾 Spot urine potassium/(g·d^-1)
Q1(< 22.50)	1.000	1.000	1.000	1.000	1.000	1.000
Q2(22.50~ < 37.03)	0.909(0.672~1.230)	0.886(0.621~1.265)	-1.145(-3.813~1.523)	-0.799(-3.083~1.486)	-0.196(-1.820~1.429)	-0.105(-1.556~1.346)
Q3(37.03~ < 56.19)	0.756(0.557~1.027)	0.807(0.563~1.156)	-3.475(-6.143~-0.807)^①	-2.379(-4.664~-0.094)^①	-1.973(-3.597~-0.348)^①	-1.490(-2.941~0.038)
Q4(≥56.19)	0.635(0.463~0.871)^①	0.633(0.436~0.918)^①	-4.405(-7.104~-1.706)^①	-3.137(-5.467~-0.807)^①	-1.570(-3.214~0.073)	-1.027(-2.507~0.454)
点尿钠钾比 Spot urine sodium-to-potassium ratio
Q1(< 2.42)	1.000	1.000	1.000	1.000	1.000	1.000
Q2(2.42~ < 3.71)	1.328(1.034~2.009)^①	1.332(0.921~1.925)	2.246(-0.447~4.939)	0.621(-1.689~2.930)	1.412(-0.217~3.041)	0.569(-0.888~2.025)
Q3(3.71~ < 5.45)	1.408(1.086~2.039)^①	1.463(1.011~2.117)^①	4.315(1.622~7.007)^①	2.867(0.544~5.190)^①	2.078(0.449~3.706)^①	1.342(-0.117~2.800)
Q4(≥5.45)	1.542(1.126~2.112)^①	1.485(1.027~2.147)^①	4.349(1.656~7.042)^①	3.256(0.943~5.568)^①	2.305(0.676~3.934)^①	1.177(-0.288~2.642)
注: 模型1, 未调整任何变量; 模型2, 二元logistic回归分析中, 调整了性别、年龄、体质量指数、文化程度、吸烟和食用低钠盐。多元线性回归分析中, 调整了性别、年龄、体质量指数、文化程度、吸烟、食用低钠盐和服用降压药。 ① P＜0.05。 Note: Model 1, no variables adjusted; Model 2, binary logistic regression analysis adjusted for gender, age, body mass index, education level, smoking, and low-sodium salt consumption. Multiple linear regression analyses were performed by adjusting for gender, age, body mass index, education level, smoking, consumption of low-sodium salts, and taking antihypertensive drugs. ① P＜0.05.

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变量 Variable	总人群 Total population^① (n=1 424)	非高血压组 Non-hypertensive patients^① (n=924)	高血压组 Hypertensive patients^① (n=500)	t/χ²值 value	P值 value
年龄/岁Age/years	45.05±12.38	41.00±11.52	52.54±10.24	-18.74	< 0.001
性别Gender				8.88	0.003
女Female	703(49.37)	483(68.71)	220(31.29)
男Male	721(50.63)	441(61.17)	280(38.83)
文化程度Education				82.09	< 0.001
小学及以下Primary and below	453(31.81)	233(51.43)	220(48.57)
初中Junior high school	592(41.57)	382(64.53)	210(35.47)
高中及以上High school and below	379(26.62)	309(81.53)	70(18.47)
吸烟Smoking				7.72	0.006
是Yes	452(31.74)	270(59.73)	182(40.27)
否No	972(68.26)	654(67.28)	318(32.72)
食用低钠盐Low-sodium salt				4.09	0.043
是Yes	189(13.27)	135(71.43)	54(28.57)
否No	1235(86.73)	789(63.89)	446(36.11)
体质量指数Body mass index/ (kg·m^-2)	24.51±3.99	23.77±3.75	25.90±4.06	-9.95	< 0.001
SBP/mmHg	128.97±18.38	119.30±10.10	146.80±16.79	-33.52	< 0.001
DBP/mmHg	81.68±11.10	76.15±7.04	91.91±9.91	-31.52	< 0.001
尿肌酐Urine creatinine /(mmol·d^-1)	10.88±6.73	11.13±7.18	10.42±5.81	-2.14	0.033
24 h尿量Urine volume /(L·d^-1)	1 397.20±496.82	1 376.10±483.90	1 436.30±518.10	2.01	0.045
合计Total	1 424(100.00)	924(64.89)	500(35.11)
注: SBP, 收缩压; DBP, 舒张压。 ①以人数(占比/%)或x±s表示。 Note: SBP, systolic blood pressure; DBP, diastolic blood pressure. ① Number of people (proportion/%) or x±s.

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中国三省成人尿钠钾水平与血压的关联

doi: 10.16462/j.cnki.zhjbkz.2025.09.012

通讯作者:
徐建伟, E-mail: xujianwei@ncncd.chinacdc.cn

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Association between urinary sodium and potassium levels and blood pressure in adults in three provinces of China

Corresponding author: XU Jianwei, E-mail: xujianwei@ncncd.chinacdc.cn

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中国三省成人尿钠钾水平与血压的关联

doi: 10.16462/j.cnki.zhjbkz.2025.09.012

通讯作者: 徐建伟, E-mail: xujianwei@ncncd.chinacdc.cn

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Association between urinary sodium and potassium levels and blood pressure in adults in three provinces of China

Corresponding author: XU Jianwei, E-mail: xujianwei@ncncd.chinacdc.cn

计量

出版历程

目录

通讯作者:
徐建伟, E-mail: xujianwei@ncncd.chinacdc.cn